1. Medicaid Spending in New York: Trends and Patterns, 2000-2005 Michael Birnbaum United Hospital Fund December 6, 2006 Funded by the New York State Department of Health

2. 2  How much did Medicaid spending in New York grow between 2000 and 2005?  How did enrollment change during this period?  What was the relationship between Medicaid enrollment increases and spending growth?  What drove Medicaid cost growth during this period? Key questions

3. 3 Medicaid Spending in New York: 2000-2005 Billions of dollars Source: United Hospital Fund analysis of CMS 64 data. Note: Spending is for federal fiscal years; administration is not included.

4. 4 National Health Expenditures: 2000-2005 Trillions of dollars Source: United Hospital Fund analysis of CMS NHE data. Note: Spending is for calendar years; 2005 NHE is projected.

5. 5 Annual Rates of Spending Growth: 2000-2005

6. 6

7. 7 Source: United Hospital Fund analysis of CMS 64 and NHE data. Note: Medicaid spending is for federal fiscal years. NHE is for calendar years; 2005 NHE is projected. The five-year average is a compound growth rate.

8. 8 2000 2001 2002 2003 2004 2005 Medicaid Enrollment in New York: 2000-2005 September 2001 DRM begins

9. 9 2000 2001 2002 2003 2004 2005 Medicaid Enrollment in New York: 2000-2005 January 2002 DRM ends

10. 10 2000 2001 2002 2003 2004 2005 Medicaid Enrollment in New York: 2000-2005 September 2002

11. 11 2000 2001 2002 2003 2004 2005 Medicaid Enrollment in New York: 2000-2005 September 2003

12. 12 2000 2001 2002 2003 2004 2005 Medicaid Enrollment in New York: 2000-2005 September 2004

13. 13 2000 2001 2002 2003 2004 2005 Medicaid Enrollment in New York: 2000-2005 Source: United Hospital Fund analysis of NYS DOH enrollment reports, September 2000 through September 2005. Note: Family Health Plus, shown separately here, is a component of Medicaid.

14. 14 Total Growth: 2000-2005

15. 15 Total Growth: 2000-2005 Source: United Hospital Fund analysis of CMS 64 and NHE data, NYS DOH enrollment reports. Note: Medicaid spending is for federal fiscal years. NHE is for calendar years; 2005 NHE is projected. The five-year average is a compound growth rate.

16. 16 Thousands of enrollees Medicaid Enrollment in New York: 2000 and 2005

17. 17 Thousands of enrollees Medicaid Enrollment in New York: 2000 and 2005

18. 18 Thousands of enrollees Medicaid Enrollment in New York: 2000 and 2005

19. 19 Thousands of enrollees Medicaid Enrollment in New York: 2000 and 2005

20. 20 Thousands of enrollees Medicaid Enrollment in New York: 2000 and 2005 Source: United Hospital Fund analysis of NYS DOH enrollment reports. Note: Children and adults do not include elderly or disabled beneficiaries. Enrollment is for September, the last month of the federal fiscal year.

21. 21 Adults accounted for 60 percent of the overall increase in Medicaid enrollment between 2000 and 2005. Medicaid enrollment increase of 1.5 million, FFY 2000-2005 Source: United Hospital Fund analysis of NYS DOH enrollment reports. Note: Children and adults do not include elderly or disabled beneficiaries.

22. 22 Increased Medicaid spending on adults accounted for about one-fourth of overall cost growth between 2000 and 2005. $13.5 billion Medicaid spending increase, FFY 2000-2005 Source: United Hospital Fund analysis of CMS 64 and MSIS data, and NYS DOH enrollment reports. Note: Children and adults do not include elderly or disabled beneficiaries. Shares may not sum to 100 percent due to rounding.

23. 23 Source: United Hospital Fund analysis of CMS 64 and MSIS data, NYS DOH enrollment reports. Note: Spending is for federal fiscal years; 2005 spending is a preliminary estimate. Medicaid Spending per Adult Enrollee (NY): 2000-2005

24. 24 Medicaid Spending per Disabled and Elderly Enrollee (NY): 2000 and 2005 Source: United Hospital Fund analysis of CMS 64 and MSIS data, NYS DOH enrollment reports. Note: Spending is for federal fiscal years; 2005 spending is a preliminary estimate. +24% +20%

25. 25 Health Care Expenditures per U.S. resident: 2000 and 2005 +41% Source: United Hospital Fund analysis of CMS NHE data. Note: Spending is for calendar years; 2005 NHE is projected.

26. 26  Medicaid spending in New York grew less than national health expenditures between 2000 and 2005.  During this period, Medicaid enrollment increased on an unprecedented scale, driven primarily by adults.  Increased spending on care for adults drove a small share of Medicaid cost growth.  Increased spending on care for the disabled and elderly drove most Medicaid cost growth. Conclusions